title: Clinical profile and predictors of in-hospital outcome in patients with heart failure: the FADOI "CONFINE" Study.
abstract: BACKGROUND
  Heart failure (HF) is a major health and social problem. Internal Medicine (IM) wards admit a high proportion of patients with HF, frequently with advanced age and comorbidities. Few recent data are available in this setting, especially on predictors of in-hospital outcome.
  
  
  METHODS
  In this observational study, we recruited patients admitted with diagnosis of HF and present in five index days, in 91 units of IM in Italy. Characteristics and management of HF, comorbidities, functional and cognitive status, and quality of life, were analyzed.
  
  
  RESULTS
  We observed 1411 patients, with a mean age of 78.7 ± 9.6 years. At admission, 81.7% of the patients were in NYHA classes III-IV. Ninety percent of the patients had at least one comorbidity. Dementia or severely impaired functional status were registered in 21.5% and 22.8% of the patients. In 89 patients (6,3%) a negative outcome (death or clinical worsening) occurred during hospitalization. A number of variables were significantly related to negative outcome by means of univariate analysis (systolic blood pressure <100 mm Hg, pulse pressure ≥ 55 mm Hg, anaemia, brain deficit, permanent bed rest, Barthel Index ≤ 30). At multivariable analysis, significant correlation was retained by anaemia and Barthel Index ≤ 30, the latter being the strongest predictor.
  
  
  CONCLUSIONS
  Real-world patients with HF and hospitalized in IM are frequently very old, frail and with multiple comorbidities. Functional and cognitive status significantly influence patients' outcome, and this could lead to a rethinking of the overall (in-hospital but also home-based) management of HF.
authors.affiliation: Internal Medicine, Hospital of Montepulciano, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Biagi
authors.forename: G
authors.initials: G
authors.lastname: Gussoni
authors.forename: I
authors.initials: I
authors.lastname: Iori
authors.forename: R
authors.initials: R
authors.lastname: Nardi
authors.forename: G
authors.initials: G
authors.lastname: Mathieu
authors.forename: A
authors.initials: A
authors.lastname: Mazzone
authors.forename: D
authors.initials: D
authors.lastname: Panuccio
authors.forename: G
authors.initials: G
authors.lastname: Scanelli
authors.forename: C
authors.initials: C
authors.lastname: Cicatello
authors.forename: C
authors.initials: C
authors.lastname: Rinollo
authors.forename: M
authors.initials: M
authors.lastname: Muriago
authors.forename: D
authors.initials: D
authors.lastname: Galasso
authors.forename: E
authors.initials: E
authors.lastname: Bonizzoni
authors.forename: G
authors.initials: G
authors.lastname: Vescovo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000401:mortality* / Q000503:physiopathology* / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D007388:Internal Medicine / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011788:Quality of Life; D020127:Recovery of Function; D012720:Severity of Illness Index